PURPOSE: Preoperative high-dose-rate (HDR) endorectal brachytherapy is well tolerated among patients with locally advanced rectal cancer. However, these studies excluded patients who previously received pelvic radiation therapy (RT). Because a favorable toxicity profile has been published for HDR endorectal brachytherapy, we evaluated this technique in patients who have previously received pelvic irradiation. METHODS AND MATERIALS: We included patients who had received pelvic irradiation for a previous pelvic malignancy and later received preoperative HDR endorectal brachytherapy for rectal cancer. Brachytherapy was delivered to a total dose of 26 Gy in 4 consecutive daily 6.5 Gy fractions. RESULTS: We evaluated 10 patients who previously received pelvic external beam radiation therapy (EBRT) alone (n=6), EBRT and brachytherapy (n=2), or brachytherapy alone (n=2). The median interval between the initial course of RT and endorectal brachytherapy was approximately 11 years (range, 1-19 years). Two patients experienced a complete pathologic response while 1 patient had a near complete pathologic response. No acute grade ≥3 toxicity was observed. No intraoperative or postoperative surgical complications were observed. CONCLUSIONS: Preoperative HDR endorectal brachytherapy is an alternative to EBRT for patients with locally advanced rectal cancer who have previously received pelvic RT.
PURPOSE: Preoperative high-dose-rate (HDR) endorectal brachytherapy is well tolerated among patients with locally advanced rectal cancer. However, these studies excluded patients who previously received pelvic radiation therapy (RT). Because a favorable toxicity profile has been published for HDR endorectal brachytherapy, we evaluated this technique in patients who have previously received pelvic irradiation. METHODS AND MATERIALS: We included patients who had received pelvic irradiation for a previous pelvic malignancy and later received preoperative HDR endorectal brachytherapy for rectal cancer. Brachytherapy was delivered to a total dose of 26 Gy in 4 consecutive daily 6.5 Gy fractions. RESULTS: We evaluated 10 patients who previously received pelvic external beam radiation therapy (EBRT) alone (n=6), EBRT and brachytherapy (n=2), or brachytherapy alone (n=2). The median interval between the initial course of RT and endorectal brachytherapy was approximately 11 years (range, 1-19 years). Two patients experienced a complete pathologic response while 1 patient had a near complete pathologic response. No acute grade ≥3 toxicity was observed. No intraoperative or postoperative surgical complications were observed. CONCLUSIONS: Preoperative HDR endorectal brachytherapy is an alternative to EBRT for patients with locally advanced rectal cancer who have previously received pelvic RT.
Authors: Shalini Moningi; Amanda J Walker; Ashkan A Malayeri; Lauren M Rosati; Susan L Gearhart; Jonathan E Efron; Elizabeth C Wick; Nilofer S Azad; Elwood P Armour; Yi Le; Joseph M Herman; Eun Ji Shin Journal: Gastrointest Endosc Date: 2015-03 Impact factor: 9.427
Authors: Shalini Moningi; Ethan B Ludmir; Praveen Polamraju; Tyler Williamson; Marcella M Melkun; Joseph D Herman; Sunil Krishnan; Eugene J Koay; Albert C Koong; Bruce D Minsky; Grace L Smith; Cullen Taniguchi; Prajnan Das; Emma B Holliday Journal: Clin Transl Radiat Oncol Date: 2019-08-27